Preventing and monitoring work-related diseases in firefighters: a literature review on sensor-based systems and future perspectives in robotic devices.

: In recent years, the necessity to prevent work-related diseases has led to the use of sensor based systems to measure important features during working activities. This topic achieved great popularity especially in hazardous and demanding activities such as those required of firefighters. Among feasible sensor systems, wearable sensors revealed their advantages in terms of possibility to conduct measures in real conditions and without influencing the movements of workers. In addition, the advent of robotics can be also exploited in order to reduce work-related disorders. The present literature review aims at providing an overview of sensor-based systems used to monitor physiological and physical parameters in firefighters during real activities, as well as to offer ideas for understanding the potentialities of exoskeletons and assistive devices

Physical Education on the Beach: An Alternative Way to Improve Primary School Children’s Skill- and Health-Related Outcomes during the COVID-19 Pandemic

: The COVID-19 restrictions could preclude children from participating in physical education (PE) interventions. This study aimed to evaluate the efficacy of a PE intervention conducted on the beach on children's skill- and health-related outcomes, as a possible alternative PE intervention that could be also applied during the COVID-19 pandemic. The study involved 106 primary school children, randomly assigned to the traditional indoor (TI) intervention or to the experimental outdoor (EO) intervention. The intervention period lasted 4 months and consisted of two 1-h sessions per week. Intervention was conducted just before the beginning of the COVID-19 pandemic. Children's anthropometric parameters (height, weight, BMI, body fat percentage, and abdominal circumference), fitness parameter (VO2peak), health parameters (resting heart rate, and systolic and diastolic blood pressure), gross motor coordination, and physical activity level were assessed before and after intervention. Both groups significantly improved fitness and motor coordination but worsened some anthropometric parameters (weight, abdominal circumference) after the intervention period. The EO group showed a higher increase of gross motor coordination than the TI group. Results of this study demonstrated that children benefited from a well-structured PE intervention conducted in the natural environment of the beach improving physical fitness and gross motor coordination. Therefore, planning outdoor PE interventions could be an alternative and safe way to encourage and implement physical activity at school during the particular period of COVID-19 pandemic

Are there sex differences in physiological parameters and reaction time responses to overload in firefighters?

Male and female firefighters work side-by-side in the same in strenuous and risky conditions. Anthropometrics, physiological, and reaction time (mean of reaction time -MRT-, and errors made -E) parameters of 12 Female and 13 Male firefighters were compared. Effect of overload (step test with and without equipment) on the MRT and E were analyzed on 3 trials (T1 = 1-1s, T2 = 0.5-1s, T3 = 0.5-0.5s), compared with a pre-test condition (basal). T-test between males and females was applied to assess differences (p<0.05) in all parameters. ANOVA with repeated measures and Bonferroni on 3 conditions of step test between males and females was applied in reaction time variables. Between MRT and E, in T1, T2 and T3 trials and the 3 test conditions, ANCOVA models with interactions were used. Differences (p<0.05) in anthropometric, physiological and reaction time data emerged across groups, and on the 3rd trials (T3 vs T1 and T2) in reaction time parameters of each group. ANCOVA showed differences (p<0.001) in E among trials. Post hoc showed significant differences in T1vsT3 and T1vsT2. MRT x trial interaction was extremely significant (P<0.001). Implementing fitness and reaction time exercise programs is important to decrease the injury risk and increase work capacity in firefighters with reference to female workers

Live Streaming vs. Pre-Recorded Training during the COVID-19 Pandemic in Italian Rhythmic Gymnastics

The SARS-CoV-2 outbreak led to an inevitable and drastic transition to online training systems. This study aimed to analyze the differences between live-streaming and pre-recorded training modalities in rhythmic gymnastics (RG) with coaches and gymnasts of different technical levels. A total of 238 coaches and 277 athletes affiliated with the Italian Gymnastics Federation (FGI) participated in the study. The data collection tool was a self-collected questionnaire structured in three sections: participant’s information, characteristics of live-streaming training, and characteristics of pre- recorded training. A 2 × 2 ANOVA was used for each numeric variable. A Pearson’s chi-squared test was used for each categorical variable. For the athletes, training frequency, motivation, and efficacy were significantly higher (p &lt; 0.05) with live streaming (3.7 ± 1.5 day/week, 3.8 ± 0.9 score and 3.8 ± 0.8 score, respectively) than with a pre-recorded modality (2.2 ± 1.7 day/week, 3.1 ± 1.2 score and 3.7 ± 0.9 score, respectively), while for coaches, significant differences (p &lt; 0.005) were found between the two modalities only for training frequency (live streaming, 3.6 ± 1.8 days/week vs. pre-recorded, 2.1 ± 1.7 days/week). The adherence (number of No:Yes) was significantly higher (p &lt; 0.05) for the live-streaming modality than for the pre-recorded modality in gold athletes (1:74 vs. 14:61, respectively), silver athletes (12:190 vs. 28:174, respectively), and gold coaches (3:63 vs. 11:55, respectively), but it was not for silver coaches. Physical preparation was performed significantly (p &lt; 0.005) more often (number of No:Yes) for live streaming than for the pre-recorded modality by gold athletes (9:66 vs. 34:41, respectively), silver athletes (25:177 vs. 77:125, respectively), gold coaches (8:58 vs. 37:29), and silver coaches (33:139 vs. 85:87, respectively). Free body technical preparation was performed significantly (p &lt; 0.005) more often (number of No:Yes) for live streaming than for the pre-recorded modality by gold athletes (15:60 vs. 39:36, respectively), silver athletes (84:118 vs. 121:81, respectively), gold coaches (10:56 vs. 38:28), and silver coaches (60:112 vs. 105:67, respectively), while no differences were found for silver athletes’ and coaches’ technical preparations for apparatus training between the two modalities. In conclusion, live streaming had greater positive effects on RG training during home confinement. However, pre-recorded training could be more effective for some types of training, depending on the technical level of the athletes

Initial Validation of the Italian version of the Volition in Exercise Questionnaire (VEQ-I)

The purpose of this study was to validate the Volition in Exercise Questionnaire in Italian language (VEQ-I). The translation and cultural adaptation of the VEQ-I was conducted using the forward-backward translation method. VEQ-I eighteen items correspond to the six-factors structure of the original version. The construct validity was verified by the confirmatory factor analysis (CFA) (CFI = 0.960; TLI = 0.943; RMSEA = 0.039; and SRMR = 0.040). The eighteen items were well distributed in six subscales and the six-factors structure of the questionnaire was supported. Internal Consistency value of the questionnaire was investigated for each subscale of the VEQ-I. Cronbach's alpha and Omega values of the Reasons, Postponing Training, Unrelated Thoughts, Self-Confidence, Approval from Others and Coping with Failure subscales were 0.76 (α) and 0.76 (ω), 0.76 (α) and 0.76 (ω), 0.87 (α) and 0.88 (ω), 0.85 (α) and 0.85 (ω), 0.70 (α) and 0.72 (ω) and 0.74 (α) and 0.74 (ω), respectively. They were acceptable in all the six subscales. The concurrent validity was assessed using the correlation among the subscales of VEQ-I measures and those contained in two questionnaires: Psychobiosocial States in Physical Education (PBS-SPE) and Exercise Motivations Inventory (EMI-2)

Sex differences in muscle quality of firefighter recruits: a new exploratory approach to evaluation

Abstract Background Firefighting is a hazardous occupation that requires optimal fitness levels as it put tremendous strain on the cardiovascular system. Poor body composition could contribute to the increased risk of cardiac events and reduced functional capacity. Objective The aims of this study were (1) to analyze the body composition of Italian firefighters, comparing males and females; and (2) to investigate if fitness values could be predictive of Muscle Quality (MQ) in male and female firefighters. Methods Anthropometric (weight, height, body mass index, and BIA) and fitness (handgrip, upper and lower body strength, and VO2max) parameters of 23 firefighters’ recruits (female = 11; male = 12; age: 36.70 ± 4.68 years; weight: 69.14 ± 12.19 kg; height: 169.30 ± 6.93 cm; BMI: 23.97 ± 2.77 kg/m2) were analyzed. An independent t test was used to evaluate sex differ- ences, and multiple linear regression with backward stepwise elimination was considered to evaluate the muscle quality index (MQI) dependence on anthropometric and fitness variables. Results Statistical differences (p < 0.05) between sex groups emerged in all anthropometric and fitness parameters and MQI. Only three variables were found significant (F(3, 19) = 4012.20, p < 0.001; R2 adjusted = 0.998). MQI values were strongly positively associated with the Handgrip test (t = 45.55; p < 0.001), and negatively associated with the Bench press test (t = −2.14; p = 0.045) and female status (t = −1.88; p = 0.075). Conclusions Our results confirm that sex and fitness parameters could be predictive of MQ values in recruits’ firefighters, and the easy evaluation of this parameter could provide helpful information for developing specific interventions for healthy lifestyle promotion in firefighters

An Integrated Care Approach to Improve Well-Being in Breast Cancer Patients

Background: Breast cancer (BC) treatment has recently been revolutionized by the introduction of newer targeted agents, that helped tailoring therapies around the single patient. Along with increased survival rates, a careful evaluation of diet, lifestyle habits, physical activity, emotional and psychological experiences linked to the treatment journey, is now mandatory. However, a true proposal for an omnicomprehensive and "integrative" approach is still lacking in literature. Methods: A scientific board of internationally recognized specialists throughout different disciplines designed a shared proposal of holistic approach for BC patients. Results: A narrative review, containing information on BC treatment, endocrinological and diet aspects, physical activity, rehabilitation, integrative medicine, and digital narrative medicine, was developed. Conclusions: In the context of a patient-centered care, BC treatment cannot be separated from a patient's long-term follow-up and care, and an organized interdisciplinary collaboration is the future in this disease's cure, to make sure that our patients will live longer and better. Trial registration: NCT05893368: New Model for Integrating Person-based Care (PbC) in the Treatment of Advanced HER2-negative Breast Cancer (PERGIQUAL). Registration date: 29th May 2023

The changing face of dietary therapy for epilepsy

Ketogenic diet is an established and effective non-pharmacologic treatment for drug-resistant epilepsy. Ketogenic diet represents the treatment of choice for GLUT-1 deficiency syndrome and pyruvate dehydrogenase complex deficiency. Infantile spasms, Dravet syndrome and myoclonic-astatic epilepsy are epilepsy syndromes for which ketogenic diet should be considered early in the therapeutic pathway. Recently, clinical indications for ketogenic diet have been increasing, as there is emerging evidence regarding safety and effectiveness. Specifically, ketogenic diet response has been investigated in refractory status epilepticus and encephalopathy with status epilepticus during sleep. New targets in neuropharmacology, such as mitochondrial permeability transition, are being studied and might lead to using it effectively in other neurological diseases. But, inefficient connectivity and impaired ketogenic diet proposal limit ideal availability of this therapeutic option. Ketogenic diet in Italy is not yet considered as standard of care, not even as a therapeutic option for many child neurologists and epileptologists. CONCLUSIONS: The aim of this review is to revisit ketogenic diet effectiveness and safety in order to highlight its importance in drug-resistant epilepsy and other neurological disorders. WHAT IS KNOWN: • Ketogenic diet efficacy is now described in large case series, with adequate diet compliance and side effects control. • Ketogenic diet is far from being attempted as a first line therapy. Its availability varies worldwide. What is New: • New pharmacological targets such as mitochondrial permeability transition and new epileptic syndromes and etiologies responding to the diet such as refractory status epilepticus are being pointed out. • Ketogenic diet can function at its best when used as a tailor-made therapy. Fine tuning is crucial

Effects of pre‐operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study

We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05-1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4-7 days or &gt;= 8 days of 1.25 (1.04-1.48), p = 0.015 and 1.31 (1.11-1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care